CHEST Guidelines-A-Newborn-Infant-With-Oxygen-Desaturation-During-S

A-Newborn-Infant-With-Oxygen-Desaturation-During-S

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The document is a detailed case study of a 1-week-old male infant who was experiencing intermittent oxygen desaturation during sleep. This infant was born at 37 weeks and 2 days through a spontaneous vaginal delivery, and the pregnancy was complicated by maternal gestational diabetes and pre-eclampsia. Despite an initial Apgar score of 9 at both 1 and 5 minutes, the infant required admission to a neonatal intensive care unit due to hypoglycemia, which stabilized with intravenous dextrose. However, by day two, he exhibited intermittent oxygen desaturation to 70% during sleep, prompting transfer to a tertiary NICU for further evaluation.<br /><br />A diagnosis of primary central sleep apnea of infancy was made based on polysomnography results, which indicated periodic breathing predominantly during non-rapid eye movement (NREM) sleep, coupled with oxygen desaturation. Treatment options considered were supplemental oxygen and caffeine citrate. Caffeine therapy was chosen, following which the infant showed marked improvement in periodic breathing and central apnea within 48 hours, necessitating a discharge with caffeine citrate and an apnea monitor.<br /><br />The study highlights primary central sleep apnea, often characterized by central apneas and periodic breathing, occurring in term infants. Although prognosis is generally positive, the document discusses the potential necessity of interventions such as oxygen supplementation and caffeine to manage the condition. By 13 months, the infant's apnea had resolved entirely, as seen in follow-up polysomnography, confirming the condition's tendency to improve with age. This case study underscores the importance of considering central sleep apnea in term infants, as appropriate treatment can effectively mitigate the risks of severe oxygen desaturation during apnea episodes.

Keywords

central sleep apnea

infant

oxygen desaturation

polysomnography

caffeine therapy

gestational diabetes

pre-eclampsia

neonatal intensive care

periodic breathing

non-rapid eye movement